Hypoxia is a major pathophysiological condition for the induction of angiogenesis, which is a crucial aspect of growth in solid tumors. In mammalian cells, the transcriptional response to oxygen deprivation is largely mediated by hypoxiainducible factor 1 (HIF-1), a heterodimer composed of HIF-1␣ and HIF-1 subunits. However, the response of endothelial cells to hypoxia and the specific involvement of HIF-␣ subunits in this process are still poorly understood. We show that human umbilical vein endothelial cells (
IntroductionAngiogenesis is the result of the combined activity of different cellular components of the tumor microenvironment and of signaling molecules that either activate or inhibit neovascularization. 1 Autocrine and paracrine (eg, derived from tumor-and/or stromalinfiltrating cells) production of growth factors promoting angiogenesis ultimately acts on endothelial cells (ECs), which by a process involving invasion of the extracellular matrix, migration, and proliferation gives rise to vessel sprouting and formation of a new vascular bed. In tumor angiogenesis, imbalance between factors promoting and inhibiting vessel formation leads to irregular and disorganized formation of a vascular network, which is nevertheless essential for tumor growth and metastasis. 2,3 Hypoxia is the major pathophysiological condition regulating angiogenesis. Increased angiogenesis in response to hypoxia is part of an adaptive response aimed at achieving increased delivery of oxygen and nutrients to tissues. 4,5 The exposure of ECs to hypoxia has been shown to occur in vivo as a result of structurally abnormal tumor vasculature. 2,6 The transcriptional response of mammalian cells to hypoxia is largely mediated by hypoxia-inducible factor-1 (HIF-1). HIF-1 is a basic helix-loop-helix transcription factor composed of an HIF-1 subunit, which is constitutively expressed, and an HIF-␣ subunit, which is strongly up-regulated under hypoxic conditions. 7 At least 3 isoforms of the HIF-␣ subunit have been identified, although HIF-1␣ and HIF-2␣ or EPAS-1 are the ones that appear to play a predominant role in the transcriptional response to hypoxia. In normoxic conditions, HIF-1␣ and HIF-2␣ are degraded by a mechanism involving hydroxylation of 2 prolyl residues, ubiquitylation, and proteasomal degradation through a VHL-dependent pathway. 8,9 Levels of HIF-1␣ are also influenced by genetic alterations, including but not limited to mutations of the VHL gene, growth factors, which increase HIF-1␣ protein synthesis by a pathway involving PI3K/AKT/mTOR and MAPK, and cytokines produced by both tumor and stromal cells. [10][11][12] While HIF-1␣ is ubiquitously expressed, HIF-2␣ was originally identified in ECs and some highly vascularized tissues and hence named endothelial PAS domain protein-1 (EPAS-1). 13,14 However, later studies have shown that HIF-2␣ is also expressed in a variety of other cell types and tissues. [15][16][17][18] The 2 HIF-␣ subunits induce transcriptional activation via interaction with hypoxia response elements (...